W. Alberto Sifuentes Giraldo: Exploring Peripheral Macrovascular Thrombosis in CAPS
W. Alberto Sifuentes Giraldo, Rheumatologist at Hospital Nuestra Señora de Sonsoles (Sacyl), shared a post on X about a recent article by Berta Vilaplana et al., published in Seminars in Arthritis and Rheumatism, adding:
“Peripheral macrovascular thrombosis in CAPS: 1 in 3 episodes, high amputation risk with arterial events
A new analysis of the CAPS Registry (843 patients) shows peripheral macrovascular thrombosis in 33.2% of episodes.
Main findings
- Events were predominantly venous (58.3%), followed by arterial (30.6%) and combined arterial-venous (11.2%).
- Both venous and arterial thromboses most often affected the lower limbs and proximal segments.
- Arterial events carried a high major-amputation risk (28 cases = 24% of arterial episodes).
- More common in men, when CAPS was the first APS manifestation, and with infection or malignancy triggers.
- Episodes without macrovascular thrombosis had more SLE, triple antiphospholipid antibody positivity, thrombotic microangiopathy features, and multiorgan involvement.
- Mortality did not differ significantly
Conclusions and implications
Peripheral macrovascular thrombosis is a common and relevant CAPS manifestation, most often presenting as proximal lower-limb deep vein thrombosis. Peripheral arterial thrombosis substantially contributes to long-term morbidity via elevated major amputation risk.
These findings highlight the need for early recognition and support distinctions between macrovascular and microvascular/TMA-dominant presentations of CAPS.
Vilaplana B, Russa A, Jerez A, et al; CAPS Registry Project Group/European Forum on Antiphospholipid Antibodies.
Peripheral macrovascular thrombosis in catastrophic antiphospholipid syndrome (CAPS): a descriptive analysis from the ‘CAPS Registry.'”
Title: Peripheral macrovascular thrombosis in catastrophic antiphospholipid syndrome (CAPS): A descriptive analysis from the “CAPS Registry”
Authors: Berta Vilaplana, Angelina Russa, Alba Jerez, Isaac Pons, Ana Ponce, Pilar Toledano, Tomeu Rossiñol, Ignasi Rodríguez-Pintó, Doruk Erkan, Gerard Espinosa, Ricard Cervera
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